title: De novo malignancy post-liver transplantation: a single center, population controlled study.
abstract: BACKGROUND
  With the growing numbers of liver transplant recipients, it is increasingly important to understand the risks of de novo malignancy after liver transplantation.
  
  
  OBJECTIVE
  To characterize the incidence of de novo malignancy after liver transplantation compared with a control non-transplant population.
  
  
  METHODS
  We studied 534 Indiana state residents undergoing liver transplantation at our center between 1997 and 2004, followed through August 2010. The incidence and predictors of malignancy were determined. The standardized incidence ratio (SIR) of cancer in our cohort was compared with age-, gender-, and period-matched state population using the Indiana State Cancer Registry.
  
  
  RESULTS
  After a mean follow-up of 5.7 ± 3.2 yr, 73 patients (13.7%) developed 80 cancers, with five- and 10-yr incidence rates of 11.7% and 24.8%, respectively. These included 24 (30%) skin, 16 (20%) hematologic, and 40 (50%) solid tumors. The most common solid cancers were aerodigestive. Compared with matched state population, liver transplant recipients had significantly higher incidence of all cancers (SIR: 3.1, 95% CI [Confidence interval]: 2.9-3.2), skin (melanoma) (SIR: 5.8, 95% CI: 4.7-7.0), hematologic (SIR: 7.1, 95% CI: 6.3-8.0), and solid (SIR: 2.7, 95% CI: 2.5-2.8) tumors.
  
  
  CONCLUSIONS
  There is a significantly increased risk of de novo malignancies after liver transplantation, highlighting the need for surveillance strategies in this population.
authors.affiliation: Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Hemant
authors.initials: H
authors.lastname: Chatrath
authors.forename: Kenneth
authors.initials: K
authors.lastname: Berman
authors.forename: Raj
authors.initials: R
authors.lastname: Vuppalanchi
authors.forename: James
authors.initials: J
authors.lastname: Slaven
authors.forename: Paul
authors.initials: P
authors.lastname: Kwo
authors.forename: A Joseph
authors.initials: AJ
authors.lastname: Tector
authors.forename: Naga
authors.initials: N
authors.lastname: Chalasani
authors.forename: Marwan
authors.initials: M
authors.lastname: Ghabril
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007196:Indiana / Q000453:epidemiology; D016030:Kidney Transplantation; D017093:Liver Failure / Q000150:complications* / Q000401:mortality / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D055815:Young Adult
keywords: de novo; liver transplantation; malignancy; population control study; standardized incidence ratio